MEDICARE: CLINICAL MENTAL SOLUTION, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1790636017
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLINICAL MENTAL SOLUTION, LLC

Provider Business Mailing Address
First Line	:	5088 STARBLAZE DR
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33463-5934
Country	:	US
Telephone Number	:	786-560-5972
Fax Number	:

Provider Business Practice Location Address
First Line	:	6655 LAKE WORTH RD
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33467-1507
Country	:	US
Telephone Number	:	561-469-8617
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	ISABEL MARIA AGUERO MILANES
Credential	:
Telephone Number	:	786-560-5972

Provider Enumeration Date	:	02/04/2026
Last Update Date	:	02/04/2026

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